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While pregnancy presents a strong motivation to seek and comply with Opioid Use Disorder (OUD) treatment, up to 80% of women relapse to illicit opioid use within six months of childbirth. Moreover, fatal overdoses are now a leading cause of maternal death in the US. The purpose of the present study was to examine babywearing as a behavioral intervention as it relates to mothers with OUDs and their urges to use illicit substances post-partum. Specifically, 1) does the intervention condition (babywearing) impact urges to use illicit substances within 9 months of delivery, and 2) does the total number of hours spent babywearing in the first 3 months impact urges to use.
Methods: We recruited mothers with a history of OUD and their newborns into the Newborn Attachment and Wellness study (within a NICU in the Southwest US). Participants (N=47, Mage=28.91; SD=5.14) represent the diversity of the region (48.9% White, 19.1% Hispanic, 12.8% BIPOC). Mothers were randomly assigned to the intervention condition (received a baby carrier with instructions to babywear daily) or the control condition (an infant rocker chair). Interviews occurred at birth, 3-, 6-, and 9-months post-delivery. At each wave, participants completed a self-report measure on their strong desire or urge to use various illicit substances in the last 3 months. We created a dummy score of urges to use illicit substances at 9 months: no urges (0) or any urges since delivery (1). Approximately 68.1% of the sample had illicit urges by 9-months. Across conditions, total babywearing hours within the newborn period ranged from 0 to 168, and was statistically higher among intervention mothers (M=61.41 hours, SD=41.60 vs M=4.19 hours, SD=10.93), t(45)=-6.51, p<.000. Total babywearing hours was recoded into 3 meaningful groups: never babywore (0, N=18), some babywearing (1-44 hours, N=13), consistent babywearing (45+ hours, i.e., minimum of 3.5 hours per week, N=16).
Results: Two Chi-Square tests of independence were used. Condition X2 (2, N=47) = 12.55, p<.001, Phi=.52 and babywearing category, X2 (2, N=47)=6.75, p=.034, Phi=.38 significantly predicted urges to use. Mothers in the intervention condition were less likely to have urges to use: 56.5% had no urges (43.5% had urges) compared to 8.3% of control mothers (91.7% had urges). Mothers who consistently babywore had significantly fewer urges to use (43.8% had urges) compared to mothers who never babywore (83.3% had urges). There was no significant group difference with some babywearing mothers.
Conclusions and Implications: There is a critical window in which health care providers have the opportunity to capitalize on mothers’ desire to abstain from substance use. Babywearing, and more specifically babywearing at least 30 minutes a day, reduced risk for urges to use illicit substances post-partum, a factor associated with relapse.